Florence Podiatry Associates LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

FLORENCE PODIATRY ASSOCIATES LLC

Practice address

510 W Cheves St
Florence, SC 29501-4448

Phone

(843) 679-9090

Fax

(843) 679-9080

NPI assigned

Sep 30, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Dwayne A Jacobus, DPM

Title

Owner

Phone

(843) 679-9090

Specialties & licenses 1

Addresses

Other identifiers 2

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Florence Podiatry Associates, LLC

  • Non-Pharmacy Dispensing Site
  • Florence, SC
  • NPI 1679849806
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399248000000",
    "number": "1821085366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 W CHEVES ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014448",
            "telephone_number": "843-679-9090",
            "fax_number": "843-679-9080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 W CHEVES ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014448",
            "telephone_number": "843-679-9090",
            "fax_number": "843-679-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORENCE PODIATRY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-30",
        "last_updated": "2014-05-05",
        "status": "A",
        "authorized_official_last_name": "JACOBUS",
        "authorized_official_first_name": "DWAYNE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-679-9090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP9918",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PD5658",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Florence Pain Solutions LLC
• Florence Pediatric Dentistry
• Florence Pharmacy LLC
• Florence Physical Therapy Associates, P.C.
• Florence Place Assisted Living & Memory Care LLC
• Florence Podiatry Associates, LLC
• Florence Primary Eye Care, PC
• Florence Radiological
• Florence School District One
• Florence School District One

• Podiatrist in Florence, SC
• Providers in Florence, SC by specialty
• Podiatrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.